Assessing feasibility of an adolescent relationship abuse prevention program for girls.

INTRODUCTION: Sexual violence and relationship abuse are prevalent among adolescents and programs promoting gender equity, reproductive justice, and healthy relationships are key strategies for prevention. While such "gender transformative" approaches appear promising for boys, they have not been evaluated among girls. This study assessed the feasibility of this community-based program, called Sisterhood 2.0, among girls in socially disadvantaged urban neighborhoods in Pittsburgh, Pennsylvania. METHODS: This quasi-experimental trial examined feasibility of Sisterhood 2.0 (n = 246), delivered through 8 weekly sessions, assessed through attendance, retention and satisfaction. Participants completed surveys at baseline and end of program assessing other relevant measures. Generalized linear mixed models estimated changes from baseline to follow up comparing intervention to control participants. RESULTS: Eleven neighborhoods were assigned to Sisterhood 2.0 (n = 5 neighborhoods) or job-readiness training (n = 6 neighborhoods). Girls were between the ages of 13 and 19, 8-10th graders (59%), and self-identified as Black (69%). Participants most often attended because they thought the program would be interesting (74%) and returned because of the women teaching the program (71%). Girls reported experiences with physical adolescent relationship abuse (ARA) (30% in both arms), emotional ARA (66% intervention; 56% control), or sexual ARA (11% intervention; 12% control). Physical ARA perpetration was high in both arms (intervention: 47%; control: 46%). Significant intervention effects were observed in recognition of abuse (ß = 0.41, 95% confidence interval 0.03-0.78). No other significant intervention effects were observed. CONCLUSIONS: Community-based gender-transformative programming for girls is feasible and may be a promising approach for addressing interpersonal violence and promoting sexual health.

Intimate Partner and Sexual Violence, Reproductive Coercion, and Reproductive Health Among American Indian and Alaska Native Women: A Narrative Interview Study.

Background: The disproportionately high prevalence of poor reproductive and sexual health outcomes among American Indian and Alaska Native (AI/AN) women is related to histories of colonization, oppression, and structural racism. Intimate partner violence (IPV) and sexual violence (SV) contribute to these health outcomes. Materials and Methods: Narrative interviews were conducted with AI/AN women from four tribal reservation communities. Interviews explored connections among sexual and reproductive health, IPV, SV, reproductive coercion (RC), and pregnancy experiences as well as women's experiences of healing and recovery. Results: Among the 56 women interviewed (aged 17-55 years, 77% were aged 40 years and younger), all described multiple exposures to violence and highlighted lack of disclosure related to sexuality, childhood abuse, SV, and historical trauma. Access to confidential reproductive health services and contraceptive education was limited. Almost half (45%) reported experiencing RC in their lifetime. Use of substances occurred in both the context of SV and for surviving after exposure to violence. Women underscored the extent to which IPV, SV, and RC are embedded in histories of colonization, racism, and ongoing oppression. Interventions that incorporate AI/AN traditions, access to culturally responsive reproductive health and advocacy services, organizations, and services that have AI/AN personnel supporting survivors, public discussion about racism, abuse, sexuality, and more accountable community responses to violence (including law enforcement) are promising pathways to healing and recovery. Conclusions: Findings may advance understanding of AI/AN women's reproductive health in the context of historical trauma and oppression. Intervention strategies that enhance resiliency of AI/AN women may promote reproductive health.